0908 Pain in OSA Patients Is Modulated by Chronic Pain History and Sex

Abstract Introduction Altered pain perception was found in OSA. However, the relationship remains unclear, possibly due to differential effects on pain of apnea-related sleep disturbance and hypoxemia, or other factors. This study examines the relationship between retrospective pain reports and PSG variables, sex, age, BMI, depression and insomnia questionnaires in patients referred for OSA evaluation. Methods From all in-lab patients between 08/2017 and 04/2021, 420 (259 women) were selected without significant cardiac, pulmonary, neurological, endocrine or psychiatric conditions; 136 had chronic pain conditions (CPC, e.g., fibromyalgia, arthritis, sciatica, musculoskeletal pain and similar). Patients filled out the Center for Epidemiologic Studies Depression Scale-Revised (CESDR), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Chronic Pain Grade Scale measuring pain intensity (CPGS-PI) and functional disability (CPGS-FD) in the preceding 6 months. CPGS-PI and CPGS-FD were outcomes in hierarchical backward regression models. Blocks of explanatory variables were: (1) age, sex, BMI; (2) AHI, SpO2-nadir, time below SpO2-90%, respiratory-related arousal index, (3) total sleep time, sleep latency, sleep efficiency, #awakenings, (4) CESDR, ISI, ESS, (5) OSA(AHI≥5), CPC presence, and sex-OSA-CPC interactions. Results Higher CPGS-PI was unrelated to the presence of OSA (AHI≥5, n=248), but was predicted by higher BMI (p=0.008), higher CESD (p 0.001), higher ISI (p=0.006), CPC presence (p 0.001), and CPC-by-sex interaction (p=0.005). Higher CPGS-FD was unrelated to OSA, but was predicted by higher BMI (p 0.001), higher CESD (p 0.001), higher ISI (p 0.011), CPC presence (p 0.001), and interactions CPC-by-OSA (p=0.017), CPC-by-OSA-by-sex (p=0.002). Analyzing the interaction terms, in the absence of CPCs OSA was unrelated to CPGS-FD, although women reported higher CPGS-FD (M=2.5±3.1) than men (M=1.4±2.3). Among patients with CPC, OSA had a differential effect on pain: women with OSA reported higher CPGS-FD (M=5.3±3.5) than women without OSA (M=4.2±3.5), while men with OSA reported lower CPGS-FD (M=2.7±3.1) than men without OSA (M=4.2±4.0). Conclusion Demographic, mood and insomnia variables affect pain experience in OSA patients. Pain experience in men and women with CPC appears to be differentially affected by OSA. Support (if any) none